Iām a Senior Cardiac Nurse at the BHF, here to answer your questions. Please do pop your questions in the comments below and Iāll do my best to help!
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Barbara_BHF
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I got diagnosed with coronary vessel spasm in June after having an angiogram.
Apparently my heart function whilst performing angiogram was fine. However, functioning on a day to day basis (basic tasks like dusting and hoovering) can be really dibilitating. Is this normal?? Am also only able to walk 15/20 mins but struggle to do this everyday.
Am currently taking 120mg of Chemydur as got taken off Tildiem LA 200mg yesterday as having reaction to them.
I am sorry to hear that undertaking some daily tasks is really difficult for you at the moment. I wonder if you have been prescribed a GTN spray? This is 'short acting' drug for angina symptoms (whereas the Chemydur is long-acting) and could be used as a prophylaxis prior to any activity which would usually provoke the angina. So for instance, you could use the spray prior to doing your hoovering or dusting to prevent the pain. I would suggest speaking to your GP about this to see if this would be suitable for you.
Hi Barbara. Just a question over rehab. I had a HA and then CA in Dec 19, and am feeling well although diagnosed with HF in March 20 due to low EF of 27% and ICD fitted in June 20. I have a brisk walk most days (3 miles) and it's quite hilly too where I live! Also do 45 min cardio session in my back garden 4 times a week. Anyway my question.... as part of my cardio rehab I do skipping, approx 600 skips done in blocks of 50 then 1 minute rest then another 50 etc. I've had different opinions from people, some saying it's ok and some not. So, does that seem to be overdoing it for my heart rehab??
It sounds like you are keeping very active and I must commend you for that.
When it comes to physical activity especially with an ICD, it is always important to have a professional's input (e.g. advice from a physical activity specialist). Usually the ICDs have specific settings and it is important to know how hard you can push yourself during exercise.
If you are currently under the heart failure team, I would suggest you speak to the team or to your nurse about a possible referral to the cardiac rehabilitation programme, where comprehensive assessments will be carried out by a physical activity specialist or a physio to determine your exercise hear rate range. However, if you are not under a HF team then please speak to your doctor about attending the cardiac rehab programme. In the mean time, I would suggest continuing with your walks but to seek further guidance before undertaking other vigorous activity.
I had bypass surgery in October 2018 at age 61. The operation went well and since discharge I've lost a couple of stones and am now back into the healthy BMI range, I've stuck to a Mediterranean diet, and I exercise to beyond the NHS guidelines. I'm a non smoker and I drink occasionally and moderately.
More importantly my HbA1c scores, which peaked at 42 mmol/mol are now back in the high 20's or low 30's, my blood pressure averages 105/62 with a resting pulse around 60, and my lipid scores are all within normal ranges.
My last cardio update with the practise nurse at my GP's was conducted over the phone. I half expected to have my medication reduced, however there's no change to my prescription.
I'm not overly concerned as I don't have any side effects and the results are all so positive. But I do have a question, what has to happen before medication is reduced? Because short of winning an olympic track and field medal I can't see what more I can do!
From your current readings, it appears you are managing your risk factors very well.
With regards to having your medications reduced, I wonder if you are referring to having a reduction in dosage or actually stopping some of the medications?
With coronary heart disease, patients tend to remain on most of their drugs after they have been prescribed. Patients who have stents fitted would be asked to stop one of their drugs (Clopidogrel or Ticagrelor) after one year unless their clinicians advice otherwise.
Unless your cardiologist discussed any medication changes with you following your surgery, the likelihood is that you would remain on the cardiac drugs prescribed. Evidence shows that the cardiac medications provide a protective feature for the heart and even though risk factors may all seem under control it still vital that patients carry on taking their prescribed cardiac medication.
Please do speak to your GP if you feel you need further input on this. They could review your cardiologist's discharge instructions with you.
I'm nearly 4 weeks post AVR and all seems to be according to plan.
I was wondering if I should get/need a home BP monitor as it looks like Face to face consultations are unlikely in near future and rehab is going to be remote also?
From your post, it seems you have been doing well as you did not mention any problems following your surgery. Buying or getting a blood pressure machine at this time would not be of benefit to you, if you have not been diagnosed with high blood pressure or been asked to do so specifically by your doctor.
If you do not have any symptoms and feel you are progressing well after your surgery, then that is a good sign and would encourage you to focus on that, i.e. getting better each day. However, if at any point you begin to experience symptoms which may feel unusual to you, then please contact your doctor.
Hi Barbara. A question about having a fuzzy head. My husband has a fuzzy head for most of each day, every day and itās getting him down. Iāve seen other posts asking about this but there donāt seem to be workarounds.
My husband has Dilated Cardiomyopathy (DCM) and has his Aortic Valve was replaced with a mechanical one a couple of years ago. His EF is around 41% , as measured by an Echo last month and is about the same as a year ago. The new valve is working well and the RHside of his heart is normal.
About 4 weeks before the Echo last month the cardiologist halved day his dose of Spironolactone to 12.5mg daily and reduced Bisoprolol to 2.5mg daily taken in two equal doses morning and evening which has helped very little, although his hands and feet are not so cold as they were, even allowing for the hot weather weāve had. His BP and heart rate are well controlled at around 120/80 and 54bpm after the changes to his meds. Heās also on Lisinopril 30mg which he takes as a split dose and Warfarin for the valve. Although the cardiologist said heād phone when the Echo results were through, he just sent a short letter to the GP stating the EF so my husband hasnāt been able to discuss the fuzzy head with the cardiologist with the benefit of the Echo results.
He takes Q10, vitamin D and Omega3 which the cardiologist is happy with.
He exercises regularly, walking our dogs each morning and cycling about 7 miles 2 times a week (weather permitting) which helps. He used to go to the gym regularly but feels itās too risky now due to Covid19. Exercise helps the fuzziness for a while.
Is there anything that can be done to alleviate the fuzziness?
I am sorry I don't have a quick answer to your question, as it appears this problem is currently under review and the cardiologist has already taken a few steps to try to resolve the problem.
As I am not familiar with your husband's full medical history, I would suggest getting in touch with the cardiologist's secretary if possible, to arrange for you to speak with the cardiologist to discuss the results of the echocardiogram in full. They may then be able to provide specific advice based on their findings.
Sorry I could not provide a specific answer to your question but hope you are able to get in touch with the cardiologist soon.
Thanks Barbara. It would have been nice if there was a simple fix and he didnāt have to bother the cardiologist but I guess thatās the way of heart conditions.
I had a HA and stent in September 19 I have struggled with stomach problems since being on medication but I am often worried its my heart.
I am also due to stop taking my blood thinner Ticagrelor but I am really worried this will cause me to have another HA. I am so anxious all of the time and its beginning to rule my life. Any advice
If you have not already done so, I would suggest speaking to your GP about this as they could prescribe you with a specific type of drug if appropriate (e.g, Omeprazole or Lansoprazole) which can help protect the lining of the stomach. It can be common for people to experience stomach discomfort when started on specific cardiac medication after having a stent fitted.
After a year, most patients will be asked to stop taking the 2nd antiplatelet, which in your case is Ticagrelor. This is in accordance with current guidelines so please do not be alarmed. You will still continue on Aspirin which also works to thin the blood.
My understanding of ectopics is double heart beats & missed beats. But if you don't have double beats are the missed beats still classed as ectopic. And if this is something that has recently started, 22 years after heart attack and cardiac arrest & 7 years after bring diagnosed with heart failure should we be concerned?
GP has stated it ectopics but has not listened to the heart beat, she did do an ecg and said all was normal but these missed beats don't happen all the time
Hi Barbara i had a heart attack last november and have since been diagnosed with connary heart spasms.Was wondering if this is a life long condition now or do they sometims go away for good.
I have been told for a couple of years now should my QRS keep on widening it will bring the need for a device closer!! I am never sure what this actually means ( Widening QRS ) Heart Failure is Moderate at 44% EF only symptom is Breathless at times for no apparent reason.
My Heart Nurse recently wrote to my GP to say I fit the criteria for a possible CRT device, but cardiologist is holding off !! I have stated I would rather have a device sooner rather than later as I am 73 next month but still very active and positive !!
Thanks Prada aka Frank W
ps100% blocked RCA and Circumflex bypassed along with 2 stents in the LAD RCA non viable !!
Afternoon, I have recently been diagnosed with microvascular angina it kicks in when i do anything on exertion, prior to condition i have done ironman triathlons now i cant run more than 500 meters, I was wondering if you could point me in the right direction to get training again i am really worried about going out and bringing on an attack .
I have been prescribed 500 mg Ranexa but these haven't made any difference i have seen on different post that people have used a spray prior to exercise i am presuming this will be like an asthma type spray.
When i was training it helped my mental health as well as fitness now i am struggling with both
I had a mild heart attack in May and because of Covid19 have not been able to have rehab or see a cardiologist, so have found this forum invaluable. My question relates to feeling light headed in the last week or so. Is this something that could be related to the heart?
hi Barbara.. 3 months ago i had a CT angiogram.. result was mild/moderate plaque disease.. i forgot to ask Cardiologist which arteries were affected.. would it be worthwhile to ask or would the possible implications be the same.. no matter which arteries are affected?..thans
Hi my self and a really close friend have had a gastric bypass mine 7 years ago hers 5 years ago ..
We both had heart surgery mine 22 months after my gastric bypass I had aortic valve replaced mechanical And a cardiac bypass .
My good friend had mitral valve mechanical replaced . We meet at post gastric surgery support group ,
Both of us really struggle with our INR level which fluctuate so quickly my friend can go from 1.2 to 12 in a day !!!
Mine is a little better I can go from 1.5 to 5 in two days .
We both have to and have always take vitamins due to the malnutrition of the gastric bypass , .
If we donāt we can have serious neurological problems which my friend has due to the Malabsorption.
We both self test as this allow us to catch our fluctuating INR , my friend is so unpredictable and she often in hospital as a result .
We donāt think this is just a coincidence. And think gastric bypass is effecting absorption of Warfrain .
I did tell cardiologists and cardiac team I had gastric bypass . But as I was 57 they recommended mechanical and also my head wasnāt I the right place understandable.
On reflection I think I should of had a bio valve , but canāt change history But may be for other that follow ! .
is their any research On the implication of gastric bypass surgery and replacement cardiac valve ?
Do you know of any one who been able to get their mechanical valve replaced for bio ?
Thank you
Kim
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